Consent & Medical Form
    家长同意书及医疗表格

    1. Student Information 学生信息









    2. Parent / Guardian Information 家长/监护人信息

    Primary Contact 主要联系人






    Secondary Contact 第二联系人







    1. I give Bangkok-Chicago Christian International School (BCCI) my permission to use my likeness or my child’s likeness in photography for publications, promotional purposes, the school’s website, press releases and coverage, and any other such purposes. I understand that neither my child nor I will receive compensation for the use of this likeness in any form. 我授权BCCI将我的肖像或孩子的肖像用于摄影，以用于出版物，宣传目的，学校的网站，新闻发布和报道以及任何其他此类目的。我了解我和我的孩子都不会因使用这种形式的任何形式而获得补偿。2. I give my permission to BCCI to take/record and share/use photographs or video files of my child to other parents/ guardians/ public for the purpose of observing classroom activities at BCCI. The photographs or video files will be available to view on a password protected website. (Note: BCCI cannot share pictures or video files without a signed consent form from every parent or guardian of each student in the classroom) 我已同意BCCI拍摄/记录并与其他父母/监护人/公众共享/使用我孩子的照片或视频文件，以便观察BCCI的课堂活动。照片或视频文件可在受密码保护的网站上查看。 （注意：如果没有教室中每个学生的每个家长或监护人的签名同意书，BCCI不能共享图片或视频文件）3. I give my permission to BCCI to apply over-the-counter topical ointments, including sunscreen to my child as necessary. I understand that it is my responsibility to supply BCCI with the ointments and the sunscreen of my choice. 我允许BCCI允许在我的孩子身上使用非处方药，包括防晒霜。我了解向BCCI提供我选择的药膏和防晒霜是我的责任。4. I give consent for my child to take part in nearby walks or excursions away from BCCI with proper supervision, when no transportation is necessary. Please note that individual permission slips will be provided for each outside learning experience where transportation is provided. 我同意我的孩子在不需要任何额外交通的情况下，在适当的监督下参加BCCI附近的步行或短途旅行。请注意，如果需要搭乘交通工具的外出学习活动需要个人许可单。



    1. Medical History 病史



    2. Allergies 过敏症





    3. Medications 药物




    4. Physical Activity Restrictions 身体活动限制


    Consent for Medical Treatment 医疗同意书

    I, the undersigned parent/guardian, hereby give permission for BCCI to seek emergency medical treatment for my child if necessary. I understand that the school will make every effort to contact me before taking action. 我，作为下方签字的家长/监护人，特此授权BCCI在必要时为我的孩子寻求紧急医疗救治。我理解学校在采取行动前会尽一切努力与我联系。

    Student Well-being & School Counseling
    学生福祉与学校心理辅导

    Our Commitment 我们的承诺

    At Bangkok-Chicago Christian International School (BCCI), we believe every child is uniquely created by God and deserves to learn in a safe, caring, and supportive environment. We are committed to promoting each student's academic, social, emotional, behavioral, and spiritual well-being. The information below helps the school better understand your child's needs and provide appropriate support when necessary.
    曼谷芝加哥基督教国际学校（BCCI）相信，每一位孩子都是上帝所珍爱、独特创造的个体，值得在安全、关怀与支持的环境中成长。学校致力于促进学生在学业、社交、情绪、行为及属灵方面的全面发展。以下资料仅用于帮助学校更了解学生的需要，并在有需要时提供适切的支持。

    1. Previous Student Support History
    曾接受过的支持服务


    2. Information You Would Like the School to Know
    希望学校了解的孩子情况

    Examples may include adjustment to a new environment, separation anxiety, friendship concerns, emotional regulation, family changes, fears, grief, or other circumstances.


    例如：适应新环境、分离焦虑、人际关系、情绪调节、家庭变动、害怕的事物、亲人离世或其他特殊情况。

    3. Significant Life Changes
    重大生活事件


    4. School Counseling Consent
    学校心理辅导知情同意


    5. Confidentiality
    保密原则

    The school counselor will make every reasonable effort to keep counseling conversations confidential and respect student privacy. However, confidentiality may be limited when there is concern about a student's safety, risk of harm to self or others, suspected abuse or neglect, or when disclosure is required by applicable laws or school policies. In such situations, only the information necessary to protect the student's well-being will be shared with appropriate individuals.

    学校心理辅导老师将尽可能保护学生的隐私，并对辅导内容予以保密。然而，当涉及学生或他人的安全风险、疑似虐待或疏忽，或法律及学校政策要求时，学校有责任向相关人员披露必要信息，以保障学生的安全与福祉。学校仅会分享保护学生所必需的信息。


    Scroll to Top